Wellspan Medical Group
Wellspan Medical Group was paid $173K by Medicaid between Oct 2018 and Sep 2024, across 9 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 61% of everything it billed.
EPHRATA, PA 17522
Next to other Family Medicine Physician providers in Pennsylvania
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Paid by month
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 33 | $1K | |
| 2019 | 17 | $1K | |
| 2020 | 93 | $5K | |
| 2021 | 784 | $36K | |
| 2022 | 1,240 | $58K | |
| 2023 | 925 | $39K | |
| 2024incomplete | 721 | $35K |
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 61% | 2,440 | 2,338 | $105K |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 35% | 986 | 944 | $60K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 2.7% | 61 | 54 | $5K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 1.3% | 24 | 24 | $2K |
| 90686 | <1% | 214 | 211 | $1K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 17 | 17 | $319.16 |
| 90670 | 0% | 25 | 25 | $0.00 | |
| 90656 | 0% | 21 | 21 | $0.00 | |
| 90698 | 0% | 25 | 25 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
Who's on the registration
| Provider | Location | Paid |
|---|---|---|
| Wellspan Medical Group | York, PA | $5.21M |
| Wellspan Medical Group | Gettysburg, PA | $1.11M |
| Wellspan Medical Group | Lititz, PA | $841K |
| Wellspan Medical Group | Lebanon, PA | $550K |
| Wellspan Medical Group | Ephrata, PA | $467K |
| Wellspan Medical Group | York, PA | $342K |
| Wellspan Medical Group | York, PA | $250K |
| Wellspan Medical Group | Lancaster, PA | $250K |
| Wellspan Medical Group | Myerstown, PA | $228K |
| Wellspan Medical Group | East Earl, PA | $136K |
| Wellspan Medical Group | Ephrata, PA | $101K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.